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Photoaging & Skin Damage

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PEORIA (309) 674-7546 MORTON (309) 263-7546 GALESBURG (309) 344-5777 PERU (815) 224-7400 NORMAL (309) 268-9980

CLINTON, IA (563) 242-3571 DAVENPORT, IA (563) 344-7546

soderstromskininstitute.com

SoderstromSkinInstitute.com

[email protected]

[email protected]

FRFOroMmYOYoUuRrDDEeRrmMAaTtoOloLOgiGsItST

PHOTOAGING & SKIN DAMAGE

  • Before You Worship The Sun
  • Who’s At Risk?

Today, many researchers and dermatologists believe that wrinkling and aging changes of the skin are much more related to sun damage than to age! Many of the signs of skin damage from the sun are pictured on these pages. The decrease in the ozone layer, increasing the sun’s intensity, and the increasing sun exposure among our population – through work, sports, sunbathing and tanning parlors – have taken a tremendous toll on our skin. Sun damage to the skin ranks with other serious health dangers of smoking, alcohol, and increased cholesterol, and is being seen in younger and younger people.
Skin types that burn easily and tan rarely are much more susceptible to the ravages of the sun on the skin than are those that tan easily, rather than burn. Light complected, blue-eyed, red-haired people such as Swedish, Irish, and English, are usually more susceptible to photo damage, and their skin shows the signs of photo damage earlier in life and in a more pronounced manner. Dark complexions give more protection from light and the sun.

NO TAN
IS A SAFE TAN!

Table of Contents

Sun Damage .............................................Pg. 1 Skin Cancer..........................................Pgs. 2-3 Mohs Micrographic Surgery ......................Pg. 4 Prevention & Protection........................Pgs. 5-6 Medications ......................................... Pgs. 7-8 Treatment Options................................Pg. 9-11

Increased pigment and blotchy discoloration secondary to sun damage.

SUN DAMAGE DURING LIFE

  • Younger
  • Older

  • Roughness
  • Fine

Wrinkling
Pre Cancer -
Sunburn

Suntan
Mottled Hyperpigmentation
Deep Wrinkling

(Lentigines T e langiectasia)

Carcinoma
Actinic Keratosis

(Cancer)
(Sun Spots)

S K I N C A N C E R

Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD.

Over 1 million skin cancers are found every year in America and they are the most common form of cancer.   Detected early, they are almost always curable.

Actinic Keratoses

Precancerous sun spots frequently seen with sun damage on “midwestern skin.”

ACTINIC KERATOSES

Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD.

BASAL CELL CARCINOMA

Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD.

Solar Lentigo/Sun Spots

Solar lentigo consists of brown

Lentigo Maligna

Begins as a small brown spots, resembling freckles and cell damage on sun exposed pigmented spot that slowly

areas of the skin. These are extends and darkens in an

frequently caused by sun irregular fashion. These

damage and can be treated with are early melanomas, in

glycolic face treatments, microthe upper layer of skin.

dermabrasion, chemical peels,

or laser resurfacing.

SOLAR LENTIGO/ SUN SPOTS

2

Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD.

2) Squamous Cell Cancer

Squamous cell carcinomas occur at the rate of 208,000 per year and can sometimes (albeit infrequently) spread to the lymph nodes. They make up 16% of skin cancers. Squamous cell cancers frequently develop in the sun damaged areas of the skin that have already formed precancerous actinic keratoses. Treatment of these cancers, premalignant areas, and the skin that generates these malignant conditions is advisable.

SQUAMOUS CELL CANCER

3) Melanoma Cancer

More than 50,000 melanomas are discovered each year, which means about 1 in 74 Americans have a lifetime risk of developing melanoma. They make up 4% of all skin cancers and if the current rate holds steady, this year one person will die each hour of melanoma. A history of sunburn is significantly associated with individuals with melanomas.

1) Basal Cell Carcinoma

Basal cell carcinomas are the most common form, and as we might expect, most frequently occur on sun exposed areas, particularly the nose, forehead and cheeks. They account for 80% of all skin cancers with over 140,000 new cases per year.
It is the most serious form of skin cancer and can be found in sun exposed areas of skin and in non-sun-exposed areas where moles have changed. Melanomas are most commonly found on men’s trunks, and women’s lower legs.

The most effective treatment for melanoma is early surgical removal, which follows early detection. Our yearly free

Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD.
Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD.

skin cancer screenings have detected many malignant melanomas, as well as all forms of skin cancer, on the citizens of central Illinois over the last two decades.

  • LENTIGO MALIGNA
  • MELANOMA CANCER

3

MOHS MICROGRAPHIC SURGERY

Mohs surgery is a highly specialized treatment for the total removal of skin cancer. This method differs from all other methods of treating skin cancer by the use of complete microscopic examination of all the tissues removed surgically, as well as detailed mapping techniques to allow the surgeon to remove all the roots and extensions of the skin cancer. and pleasant. They are completely Medicare approved and accredited by the Accreditation Association for Ambulatory Health Care, Inc.

TIPS........... FOR PROTECTING

OURSELVES FROM SUN’S DAMAGING
RAYS INCLUDE:

The procedure, performed here at Soderstrom
Skin Institute by a Mohs micrographic surgeon, is begun after the skin is injected with a local anesthetic to make it completely numb. Then the visible cancer and a very thin layer of skin are removed with a scalpel, carefully mapped, and examined microscopically. If cancer is still present under the microscope, another very thick layer of skin is removed from that exact location. This may be repeated to completely remove the cancer, and these are are called stages.

  • 1.
  • Avoiding the hot sun from 10:00am to

4:00pm.

2. 3.
Wearing a wide-brimmed hat. Wearing long-sleeved light weight shirts and blouses.

4. 5.
Wearing sunscreens all year long. Avoiding reflective surfaces such as water and snow.

Advantages in Mohs Surgery

By using the detailed mapping techniques and complete microscopic control, the Mohs surgeon can pinpoint areas involved with cancer that are otherwise invisible to the naked eye. Therefore, even the smallest microscopic root of cancer can be removed. The result is: 1) the removal of as little normal skin as possible, and 2) the highest potential of curing the cancer.

6. 7.
Minimizing sun exposure. Avoiding tanning parlors.

  • Cure Rate
  • Disclaimer

  • Any form of treatment will leave a scar.
  • Mohs surgery is the most accurate method for

removing skin cancers. In previously treated cancers, where other forms of treatment offer only 80%-90% chance of success, Mohs surgery is 95% effective.
However, because Mohs surgery removes as little normal tissue as possible, scarring is minimized. Immediately after the cancer is removed, we may choose 1) to allow the wound to heal by itself, 2) to repair the wound with stitches, or a skin graft or flap, or 3) to send the patient to the referring physician or another surgeon for wound repair. The decision is based on the safest method that will provide the best cosmetic results.

Peoria Ambulatory Surgery Center

Mohs surgery is performed in our pleasant outpatient surgery center - Peoria Ambulatory Surgery Center. There are many advantages to this same day surgery center but the key points include cost effectiveness and privacy. The staff at Peoria Ambulatory Surgery Center strive to make every surgical experience thorough, effective, efficient,

4

Actual Patient of Soderstrom Skin Institute and Carl W. Soderstrom, MD.

Mild & Severe Rhytides/ Wrinkles

Mild and severe wrinkling of the upper layer of the dermis caused by sun damage.

  • MILD RHYTIDS
  • MODERATE RHYTIDS

SUN DAMAGE AVOIDANCE &
PROTECTION SAVES LIVES

The prevention of damage to the skin from exposure to the sun’s ultraviolet (UV) rays consists largely of protection. There are several ways to protect the skin from this damage.

Sun in Moderation

Treatment for all of the different ramifications of sun damage includes a stepwise approach, designed in a thoughtful manner specifically for each individual patient. First, and most obviously, it is important to avoid further exposure to the sun and UVA and UVB rays. This can be done by following the prevention guidelines below:
1. AVOIDANCE: Avoid activities in the sun from
10:00am to 4:00pm. These are the hours of the day when the sun’s rays are the most direct and potentially the most damaging to the skin.

Sun Avoidance and Protection Saves Lives!

The sun emits two types of rays that cause
2. CLOTHING: Protect exposed areas with wide

brimmed hats and lightweight, long-sleeved shirts and blouses. A loose fitting tightly woven fabric is best because the loose fit allows for a cooling effect while the tight weave prevents penetration of the sun’s rays. Light colored fabrics reflect the sun away from the body. Gloves may be appropriate for outdoor work. damage to the skin, ultraviolet A (UVA) and ultraviolet B (UVB). UVB rays are commonly called burning rays, affecting the top layer of skin, causing pain, redness, and swelling. UVA rays penetrate deeper to the second layer of skin and are often called “tanning rays.” These UVA rays stimulate the production of pigment to protect the skin from the damaging effects of the radiation. Therefore, there is no such thing as a “healthy” tan. In addition, UVA rays cause permanent damage to the underlying support structure of the skin which results in premature wrinkling and aging effects. Over time, the radiation can cause changes at the cellular level which can result in the development of skin cancers and other nonmalignant skin lesions. Even though a tan disappears in the winter, the sun damage does not. It is permanent and cumulative. In other words, damage continues to add up year after year after year.
3. LOCATION: Remember that reflective surfaces, such as water, and even snow, intensify the sun’s damaging effects. The Earth’s atmosphere filters UV rays, as smog, dirt, and pollution. Sun damage will occur more readily on a beach by the water than on a city rooftop. Sitting in the shade offers protection from less than half of the sun’s rays. High altitudes allow a concentrated dose of UV radiation, even in the winter. Remember, it is the sun’s rays, not the temperature that is dangerous.

5

Since tanning represents the body’s response to injury, chronic exposure to ultraviolet rays, whether it be from the sun or tanning units, causes the skin to become coarse, wrinkled, and leathery in appearance.
4. MEDICATIONS: Photosensitivity, an adverse reaction to sunlight, characterized by rash, redness and/or swelling, can be a side effect of certain medications.

5. DISEASES: Some diseases can be either initiated or made worse by UVB and UVA exposure. These include polymorphous light eruption (PMLE), chronic actinic dermatitis, actinic reticuloid, lupus erythematosus, and solar urticaria (hives).
The UV light of a tanning booth also increases the risk of skin cancer. Understanding the consequences of exposure to both indoor and outdoor sources of radiation is a first step in the process of changing tanning practices, thereby reducing the risk of developing skin cancers.
6. SUNSCREENS: Sunscreens are a vital protection for everyone, even people who tan easily. These products are as necessary on the ski slope as they are on a tropical beach. Sunscreens are rated by a standardized Sun Protection Factor (SPF) based on the ability of the product to prevent sun damage. Any sun screen requires reapplication when perspiring, after swimming, or when the effectiveness has “worn off.” There are waterproof sunscreens available, but the directions listed on the label should be carefully followed. Remember to apply sunscreens to extra susceptible areas like the ears, lips, and nose. Be cautious even on cloudy, hazy days, as 70% to 80% of the sun’s damaging rays can penetrate cloud cover or water.
The Skin Cancer Foundation has declared that it is “...abundantly clear that these devices lead to an increase in visible damage to the skin and skin cancer.” (“Dark Duplicity: False Claims for Sunlamps Start Again”, Sun & Skin News, A Publication of the Skin Cancer Foundation)

8. SELF TANNING LOTIONS:

If it’s a nice golden tan you are after you may want to consider some of the self-tanning lotions that are available on the market today. These products contain an active ingredient known as dihydroxyacetone (DHA), a colorless sugar that darkens the skin by staining. DHA works by interacting with the dead surface cells found in the epidermis, or the outermost layer of the skin, producing a color change. As the dead skin cells are naturally sloughed off, the color gradually fades - typically within five to seven days of a single application. Skin

7. TANNING BOOTHS AND PARLORS:

Tanning parlors claim to offer all the good looks of a tan with none of the risks. This simply is not true. Both outdoor and indoor sources of UV light produce detrimental changes in the skin. In fact, the bulbs used in tanning beds emit two to three times the amount of UVA rays that are normally received from the sun. It has been shown that an individual who spends 30 minutes in a tanning bed is receiving the amount of sun damage equivalent to spending an entire day laying out in the sun at the beach.
Dimensions Day Spa offers self tanning lotion as well as a spray tanning technique.

6

Sunscreens:

Remember, the lips are also exposed to damage from the sun’s rays. Look for lip protection that contains sunscreen with an SPF15 or better such as Vanicream™ Lip Protectant SPF30, available at Soderstrom Skin Institute.
Further study into the effects of ultraviolet radiation on the skin demonstrated the damaging effects of UVA radiation. This has lead to a new generation of broad spectrum sunscreens that protect the skin from other UVB and UVA radiation. It is important to check the product label to determine not only how much protection the sunscreen provides (SPF), but also what kind of protection (against UVB rays or both UVB and UVA rays). There are many sunscreens available on the market today. See picture above for a variety of products available at Soderstrom Skin Institute.

What is an SPF?

SPF stands for Sun Protection Factor and is a standardized measurement of the ability of a product to prevent sun damage by absorbing radiation. During the initial testing of these products it was determined that, on the average, it takes ten minutes of sun exposure to produce a sunburn. Ideally, the SPF number tells how many times more than ten minutes an individual can stay in the sun before a burn will occur. Therefore, a product with an SPF of 8 would protect the wearer from a sunburn for eighty minutes, a factor of 15 would offer a little over two hours protection and so on. Keep in mind that ten minutes is only an average. Everyone’s tolerance to sunlight will be somewhat different. Environmental conditions such as being in and out of water, to perspiration will decrease the amount of protection offered regardless of the SPF. For maximum protection, the best rule is to reapply any sunscreen approximately every two hours.

%UVB
SPF Absorption*

  • 8
  • 87.5%

90.0% 93.3% 95.0% 96.0% 96.6% 97.4%
10 15 20 25 29 39

*Calculated using the reciprocal of SPF from the method of Sayre RM et al. A comparison of in vivo and in vitro testing of sunscreen formulas. Photochemistry and Photobiology 1979; 29: 559-566.

7

Haloperidol Henna
Olanzapine Oral contraceptives Oxaprozin Oxcarbazepine Oxytetracycline Paclitaxel Pantoprazole Paroxetine Pentobarbital Pentosan
Spironolactone St John's wort Streptomycin Sulfacetamide Sulfadiazine Sulfadoxine Sulfamethoxazole Sulfasalazine Sulfisoxazole Sulindac

Awareness Of Medications
Reacting To Sun

There are certain medication that can make our skin more sensitive to the sun. These may increase sun damage and should be avoided if you do not wear a sunscreen or if you are going to be outdoors a lot.

Herion Hydralazine Hydrochlorothiazide Hydroflumethiazide Hydroxychloroquin Hydroxyurea Hydroxyzine Hyoscyamine Ibuprofen Imipramine Indapamide Indomethacin Infliximab
Acetaminophen Acetazolamide Acetohexamide Acitretin
Citalopram
Pentostatin

Perphenazine Phenelzine Phenindamine Phenobarbital Pimozide
Sumatriptan Tacrolimus
Clemastine Clofazimine Clofibrate (Atromid-S) Clomipramine Clorazepate Clozapine
Tartrazine Terbinafine Tetracycline Thioguanine Thioridazine Thiothixene Tiagabine
Acyclovir Aldesleukin Alitretinoin
Interferon beta 1-a Interferons, alfa-2 Isocarboxazid Isoniazid
Piroxicam

  • Allopurinol
  • Co-trimoxazole

Cromolyn Cyclamate Cyclobenzaprine Cyclothiazide Cyproheptadine Dacarbazine Danazol Dantrolene Dapsone
Polythiazide Pravastatin Procarbazine Prochlorperazine Procyclidine Promazine Promethazine Propranolol Propylthiouracil Protriptyline Psoralens
Almotriptan Alprazolam

  • Isotretinoin
  • Timolol

Tiopronin Tolazamide Tolbutamide Topiramate Torsemide Tranylcypromine Trazodone Tretinoin Triamterene Triazolam Trichlormethiazide Trifluoperazine Trihexyphenidyl Trimeprazine Trimethadione Trimethoprim Trimetrexate Trimipramine Trioxsalen Tripelennamine Triprolidine Trovafloxacin Valdecoxib Valproic acid Valsartan Venlafaxine Verapamil Verteporfin Vinblastine Vitamin A Voriconazole Zalcitabine Zaleplon
Amantadine Amiloride
Itraconazole Kanamycin Kava
Aminolevulinic acid Aminosalicylate sodium Aminodarone Amitriptyline Amobarbital Amoxapine
Ketoconazole Ketoprofen Ketotifen Lamotrigine Leuprolide
Demeclocycline Desipramine Dexchlorpheniramine Diazoxide
Anagrelide Anthrax vaccine Arsenic
Levofloxacin Lincomycin Lisinopril
Pyridoxine Pyrilamine Pyrimethamine Quetiapine Quinacrine Quinapril

  • Atenolol
  • Diclofenac

Lomefloxacin

Loratadine
Atorvastatin Atropine sulfate Azatadine Azathioprine Azithromycin Benazepril Bendroflumethiazide Benzthiazide Benztropine Betaxolol Bexarotene Bisoprolol Brompheniramine Bumetanide Bupropion Butabarbital Butalbital Capecitabine Captopril
Diflunisal Diltiazem
Losartan

Dimenhydrinate Diphenhydramine Disopyramide Docetaxel

  • Loxapine
  • Quinestrol

  • Maprotiline
  • Quinethazone

  • Quinidine
  • Meclizine

Meclofenamate Medroxyprogesterone Mefenamic acid Melatonin
Quinine
Doxepin
Rabeprazole

Ramipril
Doxycycline Efavirenz
Ranitidine

Enalapril

  • Meloxicam
  • Ribavirin

Enoxacin
Meprobamate

Mercaptopurine Mesalamine Mesoridazine Metformin
Riluzole
Epirubicin
Risperidone

Ritonavir
Epoetin alfa Estazolam
Rofecoxib

Estrogens
Ropinirole

Ethacrynic acid Ethambutol Ethionamide Etodolac
Methazolamide Methenamine Methotrexate Methoxsalen Methyclothiazide Methyldopa Methylphenidate Metolazone Minocycline Minoxidil Mirtazapine Mitomycin Moexipril Molindone
Saccharin Saquinavir Scopolamine Selegiline
Carbamazepine Carisoprodol Carteolol
Felbamate
Sertraline

Sildenafil
Fenofibrate Flucytosine Fluorouracil Fluoxetine
Simvastatin Smallpox vaccine Solalol
Ziprasidone Zolmitriptan Zolpidem
Carvedilol Cefazolin Ceftazidime Celecoxib
Fluphenazine Flurbiprofen Flutamide Fluvastatin Fluvoxamine Fosinopril
Sparfloxacin

Others

Cetirizine Cevimeline
Bergamot oil*, oils of citron, lavendar, lime,

sandalwood, and cedar. (Used is perfumes and cosmetics.) Also topical exposure to citrus rind oils. Benzocaine Etretinate (Tegison) Goldsalts (Myochrysine and Solganal) Lovasatin (Mevacor) 6-methylcoumarin (Used in perfumes, shaving lotions, and sunscreens.) Musk ambrette (Used in perfumes.)
Chlorambucil Chlordiazepoxide Chlorhexidine Chloroquine Chlorothiazide Chlorotrianisene Chlorpheniramine Chlorpromazine Chlorpropamide Chlortetracycline Chlorthalidone Cinoxacin
Moxifloxacin Nabumetone Nalidixic acid Naproxen
Furazolidone Furosemide Ganciclovir Gatfloxacin Gentamicin Glimepiride Glipizide
Naratriptan Nefazodone Nifedipine Nisoldipine
Glyburide
Nitrofurantoin

Norfloxacin Nortriptyline Ofloxacin
Glycopyrrolate Gold and gold compounds Griseofulvin

* R eactions occur frequently. Note: No sunscreen can guarantee protection from a photosensitivity reaction when using any of these drugs.

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  • May 2020 for Health Professionals Who Care for Cancer Patients

    May 2020 for Health Professionals Who Care for Cancer Patients

    Systemic Therapy Update Volume 23 Issue 5 May 2020 For Health Professionals Who Care for Cancer Patients Inside This Issue: Editor’s Choice Benefit Drug List New Programs: Neoadjuvant Carboplatin for Triple-Negative New: BRLACTWAC, UGUPAPA, Pegaspargase (LKNOS, Breast Cancer (BRLACTWAC) | Apalutamide for Non- LYNOS), Bevacizumab (Pediatric), IGEV (Pediatric) | Metastatic Castration-Resistant Prostate Cancer (UGUPAPA) Deleted: GIGAVEOCAP, GIGAVEOF, SMAJIFN Drug Update NEW Protocols, PPPOs and Patient Handouts Pharmacare Update – Anticoagulants | Patient Assistance BR: BRLACTWAC | GU: UGUPAPA Programs REVISED Protocols, PPPOs and Patient Handouts Drug Shortages BR: BRAJAC, BRAJACT, BRAJACTG, BRAJACTT, BRAJACTTG, New: Alemtuzumab, Anagrelide | Updated: Hydroxyurea BRAJACTW, BRAJDAC, BRAJFEC, BRAJFECD, BRAJFECDT, Cancer Drug Manual© BRAVAC, BRLAACD, BRLAACDT, BRLATACG, BRLATWAC | New: Abemaciclib, Lurbinectedin | Revised: Apalutamide, GI: GIPGEMABR | GU: UGUPABI, UGUPENZ | LK: ULKBLIN, Durvalumab, Panitumumab, Pembrolizumab ULKMDSA | SA: SAIME | SC: SCDRUGRX | SM: USMAVDAB, ST Update Editorial Board USMAVDT, USMAVTRA, USMAVVC, USMAVVEM Membership Update Resources and Contact Information Editor’s Choice New Programs Effective 01 May 2020, the BC Cancer Provincial Systemic Therapy Program has approved the following new treatment programs. The full details of these programs can be found on the BC Cancer website in the Chemotherapy Protocols section. Breast Neoadjuvant Carboplatin for Locally Advanced, Triple-Negative Breast Cancer (BRLACTWAC) — The Provincial Systemic Therapy Program has approved the addition of carboplatin to the standard taxane- anthracycline neoadjuvant chemotherapy regimens, for patients with stage II and higher triple-negative breast cancer. This regimen consists of carboplatin (given every 3 weeks) in combination with weekly paclitaxel, followed by doxorubicin-cyclophosphamide (AC given every 2 or 3 weeks). Filgrastim support is available for the dose-dense AC option.
  • Inside This Issue

    Inside This Issue

    Volume 5 | Issue 1 | SkinCare Physicians | 2008 Edition 1244 Boylston Street, Chestnut Hill, MA 02467 | Phone: (617) 731-1600 | Fax: (617) 731-1601 SKINCARE PRESCRIPTION ARRIVES ! After years of exhaustive research and development, on the market, it can be confusing. To simplify SkinCare Physicians is proud to introduce our the skin care process, we have chosen the most new proprietary line of products, SKINCARE innovative and important ingredients available to PRESCRIPTION. With over 100 years of combined create a line of 8 products that our patients can use experience and expertise in skin care, the daily to care for their skin. dermatologists at SkinCare Physicians are uniquely positioned to develop this innovative product line. Unlike all the other products out there, SKINCARE The 8 products include: PRESCRIPTION is different. • Cleanser • Exfoliator The concept behind SKINCARE PRESCRIPTION is • Day Anti-Aging Moisturizer AHA with SPF 15 simple: provide a small group of carefully chosen • Night Anti-Aging Moisturizer with Retinol products that actually improve your skin, and at a • Anti-Aging Eye Cream reasonable price. Most patients use many different • Intensive Anti-Wrinkle Moisturizer (with the products, are never sure just which ones to use SkinCare Physicians special formula) when, and pay too much for them. Every day patients • Age Prevention Vitamin C Serum ask us about the products they should use to keep • Age Reversal Glycolic Acid Serum 10% their skin healthy and young looking, and because there are so many different products to choose from ( continued on page 2 ) YOUTH IN A SYRINGE: THE NEW WAY TO GET DRAMATIC RESULTS WITH FILLERS AND BOTOX INSIDE THIS ISSUE: While it may sound too good to be true, it has never lines between the eyes by combining Restylane been easier to achieve extraordinary results that can or Juvederm with Botox, creating improvement make you look younger in minutes.
  • Ultraviolet Irradiation Induces MAP Kinase Signal Transduction Cascades That Induce Ap-L-Regulated Matrix Metalloproteinases That Degrade Human Skin in Vivo

    Ultraviolet Irradiation Induces MAP Kinase Signal Transduction Cascades That Induce Ap-L-Regulated Matrix Metalloproteinases That Degrade Human Skin in Vivo

    Molecular Mechanisms of Photo aging and its Prevention by Retinoic Acid: Ultraviolet Irradiation Induces MAP Kinase Signal Transduction Cascades that Induce Ap-l-Regulated Matrix Metalloproteinases that Degrade Human Skin In Vivo GaryJ. Fisher and John J. Voorhees Department of Dennatology, University of Michigan, Ann Arbor, Michigan, U.S.A. Ultraviolet radiation from the sun damages human activated complexes of the transcription factor AP-1. skin, resulting in an old and wrinkled appearance. A In the dermis and epidermis, AP-l induces expression substantial amount of circumstantial evidence indicates of matrix metalloproteinases collagenase, 92 IDa that photoaging results in part from alterations in the gelatinase, and stromelysin, which degrade collagen and composition, organization, and structure of the colla­ other proteins that comprise the dermal extracellular genous extracellular matrix in the dermis. This paper matrix. It is hypothesized that dermal breakdown is followed by repair that, like all wound repair, is reviews the authors' investigations into the molecular imperfect. Imperfect repair yields a deficit in the struc­ mechanisms by which ultraviolet irradiation damages tural integrity of the dermis, a solar scar. Dermal the dermal extracellular matrix and provides evidence degradation followed by imperfect repair is repeated with for prevention of this damage by all-trans retinoic acid each intermittent exposure to ultraviolet irradia­ in human skin in vivo. Based on experimental evidence tion, leading to accumulation of solar scarring, and a working model is proposed whereby ultraviolet ultimately visible photoaging. All-trans retinoic acid irradiation activates growth factor and cytokine receptors acts to inhibit induction of c-Jun protein by ultraviolet on keratinocytes and dermal cells, resulting in down­ irradiation, thereby preventing increased matrix metallo­ stream signal transduction through activation of MAP proteinases and ensuing dermal damage.
  • Photodermatoses  Update Knowledge and Treatment of Photodermatoses  Discuss Vitamin D Levels in Photodermatoses

    Photodermatoses  Update Knowledge and Treatment of Photodermatoses  Discuss Vitamin D Levels in Photodermatoses

    Ashley Feneran, DO Jenifer Lloyd, DO University Hospitals Regional Hospitals AMERICAN OSTEOPATHIC COLLEGE OF DERMATOLOGY Objectives Review key points of several photodermatoses Update knowledge and treatment of photodermatoses Discuss vitamin D levels in photodermatoses Types of photodermatoses Immunologically mediated disorders Defective DNA repair disorders Photoaggravated dermatoses Chemical- and drug-induced photosensitivity Types of photodermatoses Immunologically mediated disorders Polymorphous light eruption Actinic prurigo Hydroa vacciniforme Chronic actinic dermatitis Solar urticaria Polymorphous light eruption (PMLE) Most common form of idiopathic photodermatitis Possibly due to delayed-type hypersensitivity reaction to an endogenous cutaneous photo- induced antigen Presents within minutes to hours of UV exposure and lasts several days Pathology Superficial and deep lymphocytic infiltrate Marked papillary dermal edema PMLE Treatment Topical or oral corticosteroids High SPF Restriction of UV exposure Hardening – natural, NBUVB, PUVA Antimalarial PMLE updates Study suggests topical vitamin D analogue used prophylactically may provide therapeutic benefit in PMLE Gruber-Wackernagel A, Bambach FJ, Legat A, et al. Br J Dermatol, 2011. PMLE updates Study seeks to further elucidate the pathogenesis of PMLE Found a decrease in Langerhans cells and an increase in mast cell density in lesional skin Wolf P, Gruber-Wackernagel A, Bambach I, et al. Exp Dermatol, 2014. Actinic prurigo Similar to PMLE Common in native
  • Far-Infrared Suppresses Skin Photoaging in Ultraviolet B-Exposed Fibroblasts and Hairless Mice

    Far-Infrared Suppresses Skin Photoaging in Ultraviolet B-Exposed Fibroblasts and Hairless Mice

    RESEARCH ARTICLE Far-infrared suppresses skin photoaging in ultraviolet B-exposed fibroblasts and hairless mice Hui-Wen Chiu1,2, Cheng-Hsien Chen1,3,4, Yi-Jie Chen1, Yung-Ho Hsu1,4* 1 Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei, Taiwan, 2 Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, 3 Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan, 4 Department of Internal Medicine, School of Medicine, College of a1111111111 Medicine, Taipei Medical University, Taipei, Taiwan a1111111111 [email protected] a1111111111 * a1111111111 a1111111111 Abstract Ultraviolet (UV) induces skin photoaging, which is characterized by thickening, wrinkling, pigmentation, and dryness. Collagen, which is one of the main building blocks of human OPEN ACCESS skin, is regulated by collagen synthesis and collagen breakdown. Autophagy was found to Citation: Chiu H-W, Chen C-H, Chen Y-J, Hsu Y-H block the epidermal hyperproliferative response to UVB and may play a crucial role in pre- (2017) Far-infrared suppresses skin photoaging in venting skin photoaging. In the present study, we investigated whether far-infrared (FIR) ultraviolet B-exposed fibroblasts and hairless mice. PLoS ONE 12(3): e0174042. https://doi.org/ therapy can inhibit skin photoaging via UVB irradiation in NIH 3T3 mouse embryonic fibro- 10.1371/journal.pone.0174042 blasts and SKH-1 hairless mice. We found that FIR treatment significantly increased procol- Editor: Ying-Jan Wang, National Cheng Kung lagen type I through the induction of the TGF-β/Smad axis. Furthermore, UVB significantly University, TAIWAN enhanced the expression of matrix metalloproteinase-1 (MMP-1) and MMP-9.
  • Urticaria from Wikipedia, the Free Encyclopedia Jump To: Navigation, Search "Hives" Redirects Here

    Urticaria from Wikipedia, the Free Encyclopedia Jump To: Navigation, Search "Hives" Redirects Here

    Urticaria From Wikipedia, the free encyclopedia Jump to: navigation, search "Hives" redirects here. For other uses, see Hive. Urticaria Classification and external resourcesICD-10L50.ICD- 9708DiseasesDB13606MedlinePlus000845eMedicineemerg/628 MeSHD014581Urtic aria (or hives) is a skin condition, commonly caused by an allergic reaction, that is characterized by raised red skin wheals (welts). It is also known as nettle rash or uredo. Wheals from urticaria can appear anywhere on the body, including the face, lips, tongue, throat, and ears. The wheals may vary in size from about 5 mm (0.2 inches) in diameter to the size of a dinner plate; they typically itch severely, sting, or burn, and often have a pale border. Urticaria is generally caused by direct contact with an allergenic substance, or an immune response to food or some other allergen, but can also appear for other reasons, notably emotional stress. The rash can be triggered by quite innocent events, such as mere rubbing or exposure to cold. Contents [hide] * 1 Pathophysiology * 2 Differential diagnosis * 3 Types * 4 Related conditions * 5 Treatment and management o 5.1 Histamine antagonists o 5.2 Other o 5.3 Dietary * 6 See also * 7 References * 8 External links [edit] Pathophysiology Allergic urticaria on the shin induced by an antibiotic The skin lesions of urticarial disease are caused by an inflammatory reaction in the skin, causing leakage of capillaries in the dermis, and resulting in an edema which persists until the interstitial fluid is absorbed into the surrounding cells. Urticarial disease is thought to be caused by the release of histamine and other mediators of inflammation (cytokines) from cells in the skin.
  • Dear Editor, Photo-Onycholysis Due to Tetracyclines

    Dear Editor, Photo-Onycholysis Due to Tetracyclines

    Dear EditOr, Photo-onycholysis Due to Tetracyclines: a Case Report (Tetrasiklin Kulammma Baglz Fotoonikolizis: Olgu Sunumu) Mehmet Kose Assist. Prof.1 M.D. Department of Pediatrics Erciyes University Medical Faculty Photo-onycholysis refers to separation of the nail plate from the nail bed after [email protected] exposure to ultraviolet light. Drug induced photo-onycholysis is seen most commonly with tetracycline. Harun Y1lmaz M.D. Department of Pediatrics A-12-years old boy was admitted to our pediatric department because of fever and Erciyes University Medical Faculty arthralgia. He was diagnosed as Brucellosis and treated with rifampin (20 mglkg/24hr) Kaz•m Ozum and tetracycline (30mg/kg/24hr in 3 divided oral doses). Seven days later pinkish­ Prof., M.D. purple discoloration and onycholysis developed on his fingernails. Two weeks later Department of Pediatrics Erciyes University Medical Faculty his fingernails darkened to a purple-black color and onycholysis became evident [email protected] (Picture 1). He was admitted again. Toenails were normal. Tetracycline was discontinued after 14 days of treatment and trimethoprim- sulfamethoxizole was Selim Kurtoglu Prof., M.D. added to therapy. Two months later, the nail changes resolved spontaneously. Department of Pedi atrics Erciyes University Medica l Facu lty Photosensitivity is a well-recognized complication of tetracyclines. Photo-onycholysis selimk@e rciyes.edu.tr has been observed with many of the tetracyclines usually appearing more than 2 weeks commencing drug administration (I, 2). It was first described by Segal as photosensitivity fo llowed by discoloration of the nails and onycholysis (3). Tetracyclines were reported to cause pseudoporphyria, cutaneous pigmentation, erythema multiforme, toxic epidermal necrolysis, Steven-Johnson Syndrome, fixed drug eruptions, pruritis, urticaria and vasculitis (2, 4).